Basic Information
| Provider Information | |||||||||
| NPI: | 1588899405 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GIRARD | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | DENIS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | UCONN MEDICAL GROUP | ||||||||
| Address2: | 263 FARMINGTON AVENUE | ||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060300001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606798080 | ||||||||
| FaxNumber: | 8606791430 | ||||||||
| Practice Location | |||||||||
| Address1: | 270 FARMINGTON AVE | ||||||||
| Address2: | #352 | ||||||||
| City: | FARMINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060321909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606761110 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2009 | ||||||||
| LastUpdateDate: | 09/18/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208C00000X | 056499 | CT | Y | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery |
No ID Information.